This invention relates to catheters. The invention relates particularly to implantable catheters and a method of implanting catheters in a living body to provide, for example, access to the peritoneal cavity for peritoneal dialysis.
Peritoneal dialysis has long been recognized as a treatment for end stage renal disease but it was not a commonly practiced or preferred treatment until the introduction of Continuous Ambulatory Peritoneal Dialysis ("CAPD"). CAPD is described in U.S. Pat. No. 4,239,041, issued Dec. 16, 1980 to Popovich et al. Before CAPD, the primary problems associated with peritoneal dialysis were recurrent peritonitis and the inefficiency of the dialysis procedure itself, resulting in poor patient rehabilitation.
CAPD is substantially more efficient than earlier methods of peritoneal dialysis and it has increasingly gained popularity as a treatment for end stage renal disease. Also, CAPD to a great extent has solved the problem of progressive uremic syndrome associated with Intermittent Peritoneal Dialysis. However, the risk of infection, particularly peritonitis, associated with peritoneal dialysis remains a problem and is the primary factor inhibiting the commitment of large numbers of patients to peritoneal dialysis, or more particularly, CAPD.
Instances of peritonitis associated with peritoneal dialysis can be most directly attributed to an inadequate bacteriological barrier present in the catheter access to the peritoneal cavity. Efforts to reduce instances of peritonitis have been marginally successful and have dealt primarily with the connection of the dialysis fluid bag to the catheter tubing as described in U.S. Pat. No. 4,620,845 issued Nov. 4, 1986 to Popovich et al. Catheter tunnel and exit site infections remain a problem. There continues to be a need for improved catheters and methods for implanting catheters that result in decreased risk of infection.